Page:United States Statutes at Large Volume 111 Part 1.djvu/496

 Ill STAT. 472 PUBLIC LAW 105-33 —AUG. 5, 1997 in section 1861(v)(l)(L) of such Act, as those limits would otherwise be in effect on September 30, 1999. SEC. 4604. PAYMENT BASED ON LOCATION WHERE HOME HEALTH SERVICE IS FURNISHED. (a) CONDITIONS OF PARTICIPATION. —Section 1891 (42 U.S.C. 1395bbb) is amended by adding at the end the following: "(g) PAYMENT ON BASIS OF LOCATION OF SERVICE.^A home health agency shall submit claims for payment for home health services under this title only on the basis of the geographic location at which the service is furnished, as determined by the Secretary.". (b) WAGE ADJUSTMENT.— Section 1861(v)(l)(L)(iii) (42 U.S.C. 1395x(v)(l)(L)(iii)) is amended by striking "agency is located" and inserting "service is furnished". 42 USC I395x (c) EFFECTIVE DATE. —The amendments made by this section '^oteapply to cost reporting periods beginning on or after October 1, 1997. Subchapter B—Home Health BeneHts SEC. 4611. MODIFICATION OF PART A HOME HEALTH BENEFIT FOR INDIVIDUALS ENROLLED UNDER PART B. (a) IN GENERAL.— Section 1812 (42 U.S.C. 1395d) is amended— (1) in subsection (a)(3), by striking "home health services" and inserting "for individuals not enrolled in part B, home health services, and for individuals so enrolled, post-institutional home health services furnished during a home health spell of illness for up to 100 visits during such spell of illness"; and (2) in subsection (b), by adding after and below paragraph (3) the following: "Payment under this part for post-institutional home health services furnished an individual during a home health spell of illness may not be made for such services beginning after such services have been furnished for a total of 100 visits such spell.". (b) POST-INSTITUTIONAL HOME HEALTH SERVICES DEFINED.— Section 1861 (42 U.S.C. 1395x), as amended by sections 4103(a), 4104(a), 4105(a), 4106(a), and 4454, is amended by adding at the end the following: "Post-Institutional Home Health Services; Home Health Spell of Illness "(tt)(l) The term 'post-institutional home health services' means home health services mmished to an individual— "(A) after discharge from a hospital or rural primary care hospital in which the individual was an inpatient for not less than 3 consecutive days before such discharge if such home health services were initiated within 14 days after the date of such discharge; or "(B) after discharge from a skilled nursing facility in which the individual was provided post-hospital extended care services if such home health services were initiated within 14 days after the date of such discharge. "(2) The term 'home health spell of illness' with respect to any individual means a period of consecutive days— "(A) beginning with the first day (not included in a previous home health spell of illness)(i) on which such individual is

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